Quality improvement is a necessary exercise for any developing organisation. With the changes currently taking place in the NHS, particularly the relocation of services from secondary care to primary care, it is vital that general practice nurses (GPNs) are able to review and make improvements to their practice. This article reviews the policies that are changing the landscape of primary care, examines the benefits of quality improvement initiatives and provides an exemplar of an effective quality improvement training programme. The author argues that the NHS cannot meet the healthcare needs of the population without a sustained and comprehensive commitment to effective quality improvement as its principal strategy.
In 2019, an indemnity scheme was introduced in England, covering all staff working in general practice. Although the scheme covers work delivered under an NHS contract, there are certain exceptions, including private vaccinations. Here, Helene Irvine, nurse adviser, and Michelle Lombardi, primary care director, both at Wessex Local Medical Committees, look at the scheme and aim to clarify the finer details on who and what is covered, and what, if any, extra indemnity nurses and healthcare assistants (HCAs) must obtain to ensure that their work is fully covered.
Welcome to this latest issue of GPN. We are delighted to share the latest news in the world of Education for Health, including our move to new premises, and present opportunities for you to get involved with us as a student or partner. As always, we hope that you enjoy this issue of the journal and our news update.
In each issue of the Journal of General Practice Nursing, we investigate a topic currently affecting our readers. With more and more patients being seen with complex wounds in primary care, here we consider Are we asking GPNs to become wound care experts?
Chronic oedema is a perennial challenge for nurses in primary care, consuming a large proportion of time, energy and resources. Ironically, chronic oedema is both a contributory factor and a consequence of impaired mobility, infection, or wounds and delayed healing. With growing numbers of older people with multiple and complex conditions that limit their mobility, and obesity on the increase, the prevalence of chronic oedema is predicted to rise. With reports of a current prevalence of 6:1000 (National Lymphoedema Partnership [NLP], 2019), this is a depressing prediction.
People with common health conditions, such as diabetes and heart disease, can keep their health condition invisible to the outside world. Unless they want to share their medical history, nobody else need know there is anything different about them. The same cannot be said for skin conditions such as acne, psoriasis and eczema, which, while not lifethreatening, can exact a serious toll on the self-esteem and confidence of people who experience them. While these skin conditions also involve significant discomfort, it is the psychological implications that can stay with people throughout their lives.
My personal experience of the impact smoking can have on loved ones has fuelled my interest in smoking cessation. Furthermore, the percentage of current smokers in Swindon where I live and work is above the UK average, and this may lead to higher numbers of deaths and hospital admissions directly related to smoking. This is worrying because it is the first time smoking prevalence in Swindon has risen above the UK average since records began in 2012 (Office for National Statistics [ONS], 2019).
Whether it is a family member or a friend, alcoholism can affect people physically as well as emotionally, mentally and financially. The severe impact of domestic abuse means that many victims struggle to talk about what they are going through; mainly because of fear, guilt and shame.
Wound care costs are rising in the UK. Therefore, improved systems of care to address the clinical and economic burden on our healthcare provision is needed (Guest et al, 2015). It is reported that most chronic wounds contain biofilm. With an increasing understanding and acceptance of the role of biofilm within non-healing wounds, it is now widely recognised that wound treatment plans should incorporate methods to address the potential presence of biofilm (International Wound Infection Institute [IWII], 2016). The longer a wound remains open, the greater the risk of a biofilm developing and infection risk increasing (Percival et al, 2017).
